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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
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Heterotopic Ossification After Shoulder Arthroplasty: A Systematic Review
Fahad A Nadeem1, Caleb V Hayes, James R Jones
1From the Heersink School of Medicine, University of Alabama at Birmingham (Nadeem and Hayes), and the Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL (Jones, Hargreaves, Brabston, Casp, Momaya, and Evely).
The Journal of the American Academy of Orthopaedic Surgeons
|December 11, 2024
Summary
Heterotopic ossification (HO) affects 28% of shoulder arthroplasty patients, often asymptomatically. Male patients and those with osteoarthritis or cuff tear arthropathy face higher risks, with NSAIDs showing no preventative benefit.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Regenerative Medicine
Background:
- Shoulder arthroplasty incidence is rising.
- Heterotopic ossification (HO) is an understudied complication of shoulder arthroplasty.
- HO involves abnormal extraskeletal bone growth in soft tissues.
Purpose of the Study:
- To systematically review the incidence of HO after shoulder arthroplasty.
- To identify risk factors associated with HO development.
- To explore potential management strategies for HO.
Main Methods:
- Systematic literature search of PubMed, Embase, and Ovid Medline in June 2023.
- Inclusion of 6 studies involving 1,028 patients and 1,038 shoulders.
- Duplicate search and quality assessment of all included studies.
Main Results:
- HO occurred in 28% of shoulders post-arthroplasty, symptomatic in 12%.
- Increased risk observed in male patients and those with osteoarthritis and cuff tear arthropathy.
- Revision surgery had a low rate (<2%) of HO-related intervention; NSAIDs showed no preventative effect.
Conclusions:
- HO is a significant complication in 28% of shoulder arthroplasties, frequently asymptomatic.
- Male sex and specific pre-existing conditions (osteoarthritis, cuff tear arthropathy) are risk factors.
- Current evidence suggests NSAIDs do not prevent HO, warranting further investigation.
